Abstract

MOPE086 - Poster Exhibition

Incident bone fracture in men with, or at risk for, HIV-infection in the Multicenter AIDS Cohort Study (MACS), 1996-2011

V. Walker Harris¹, K. Althoff², S. Reynolds², F. Palella³, L. Kingsley⁴, M. Danielson⁵, J. Lake⁶, T. Brown<sup>1

1</sup>Johns Hopkins Univ. School of Medicine, Medicine, Baltimore, United States, ²Johns Hopkins Bloomberg School of Public Health, Epidemiology, Baltimore, United States, ³Northwestern University Feinberg School of Medicine, Infectious Diseases, Chicago, United States, ⁴University of Pittsburgh School of Medicine, Infectious Diseases and Microbiology, Pittsburgh, United States, ⁵University of Pittsburgh School of Medicine, Infectious Diseases, Pittsburgh, United States, ⁶University of California at Los Angeles, Medicine, Los Angeles, United States

Background: Limited data are available comparing fracture incidence in HIV-infected (HIV+) and demographically similar HIV-uninfected (HIV-) persons.
Methods: Between October 1996 and 2011, fractures related to osteoporosis according to the FRAX definition (i.e. fracture of the hip, humerus, forearm, or spine) were prospectively reported or recalled during semi-annual study visits among men ≥30 years of age. Crude incidence rates (IR) per 100 person-years (PY), adjusted rate ratios (aIRR), and 95% confidence intervals ([,]) were estimated using Poisson regression models with an interaction term for age (30-49, 50-64, ≥65 years) and HIV status.
Results: Among 5,106 men during 73,548 person-visits, 103 FRAX-defined fractures (53 HIV+, 50 HIV-) were reported. The crude IR of FRAX-defined fracture was 0.15 fractures/100 PY in HIV+ and 0.13 fractures/100 PY in HIV- men. After adjusting for body mass index (BMI) and race, the incidence rate of FRAX-fracture increased with age (30-49yo: reference; 50-64yo aIRR=1.19 [0.78, 1.83]; ≥65yo: aIRR=2.93 [1.48, 5.80]) and HIV-infection (IRR=1.38 [0.93, 2.04]). The interaction of age and HIV status approached statistical significance (p=0.14). Compared to HIV- men age 30-49, the incidence rates of FRAX-defined fracture increased with age and were higher in HIV+ men compared to HIV- men, after adjustment for BMI and race (figure).
Figure: Incidence rate ratios and 95% confidence intervals for FRAX-defined fractures in HIV+ and HIV- men in the Multicenter AIDS Cohort Study, by age and HIV status


[Fig 1]


Conclusions: The rate of incident FRAX-defined, osteoporosis-related bone fractures in HIV+ and HIV- men increased with age. The increasing fracture rate is apparent in HIV+ men at younger ages as compared to HIV- men. These data provide support for recommendations for osteoporosis screening in HIV-infected men between ages 50-70 years.